Module 10.1 Stress: What it is and What it Does to the Body

Module 10.2 Psychological Factors in Physical Illness

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Module 10.1

Stress: What it is and
What it Does to the Body

Stress is an important area of study in health psychology. What are the sources of stress in our lives? How does stress affect our psychological and physical functioning?

Mind

Body

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Unlike the Cartesian belief in a dualism between body and mind, modern scientists recognize that mind and body are closely related in a reciprocal relationship: mind affects body and body affects mind.

Health psychology is the field of study that seeks to determine the importance of psychological factors in illness, as well as in prevention and health maintenance. It is defined in the text as the specialty in psychology that focuses on the interrelationships between psychological factors and physical health.

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Stress

Disaster

Bills

Shopping

Lost Wallet

Car Trouble

Moving

© Cengage Learning

Stress is defined in the text as a demand on the organism to adjust or adapt. When stress overtaxes our coping abilities, it leads to a state of emotional or physical suffering called distress.

 

Researchers have discovered that minor stressors like moving, experiencing changes in household responsibilities, etc. can add up to be as stressful as a major traumatic event like a divorce or disaster.

 

The experience of feeling stressed depends largely on cognitive processes; going on a new date is exciting for some, terrifying for others. People’s appraisals of events are very subjective and influence the effect of the event.

 

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Source: From Physical Symptoms of Stress: American Psychological Association, Stress in American Findings. Copyright © 2010 American Psychological Association. Reprinted by permission.

Clearly stress is very subjective, and individual responses to varying levels and types of stress are quite varied.

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Types of Stressors

Hassles

Life Events

Frustration

Conflict

Traumas

Digital Visions/Jupiter Images

John Fedele/Blend Images/Getty Images

Psychologists have identified a number of different types of stressors (sources of stress):

Hassles are daily annoyances of everyday life, such as traffic jams. Hassles may contribute to chronic stress.

Life events (also called life changes) are significant changes in life circumstances, such a starting or losing a job, that require readjustment.

Frustration is an internal state of tension brought about by the thwarting of goal-directed behavior.

Conflict involves pressure that occurs when one faces two incompatible goals that require resolution.

Traumatic stressors is a severe source of stress that can tax our coping abilities to the max.

 

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Approach-Approach Conflict

G

P

G

M

M

Conflict occurs when two or more incompatible motivations or behavioral impulses compete for expression. Three types of conflict have been studied extensively:

 

The approach-approach conflict occurs when a person has a choice between two attractive goals. This tends to be the least stressful type of conflict to resolve.

 

In these slides, P = Person, M = Motivation, and G = Goal

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Avoidance-Avoidance Conflict

G

P

G

M

M

The avoidance-avoidance conflict occurs when a choice must be made between two unattractive goals. The person may vacillate between the two goals or put off making a choice for as long as possible.

 

In these slides, P = Person, M = Motivation, and G = Goal

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Approach-Avoidance Conflict

G

P

M

M

The approach-avoidance conflict occurs when a choice must be made about whether to pursue a single goal that has both attractive and unattractive aspects. You may be drawn by the positive features of the goal, only to be repelled by the negative features as you get closer. In a multiple approach-avoidance conflict (not shown here), there are two or more competing goals, each of which has positive and negative features.

 

In these slides, P = Person, M = Motivation, and G = Goal

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Multiple

Approach-Avoidance

Conflict

G

P

G

G

G

M

M

M

M

M

M

M

M

The multiple approach-avoidance conflict, there are two or more competing goals, each of which has positive and negative features.

 

In these slides, P = Person, M = Motivation, and G = Goal

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Posttraumatic Stress Disorder

PTSD involves enduring psychological disturbance attributed to the experience of a major traumatic event – seen after war, rape, major disasters, etc. Symptoms include re-experiencing the traumatic event in the form of nightmares and flashbacks, emotional numbing, alienation, problems in social relations, and elevated arousal, anxiety, and guilt.

 

This video we listen to a young woman describe her symptoms of posttraumatic stress disorder after being raped.

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Primary symptoms include:

  • Avoidance of cues associated
    with the trauma
  • Re-experiencing
    the traumatic event
  • Impaired functioning
  • Heightened arousal
  • Emotional numbing

Posttraumatic Stress Disorder

PTSD involves enduring psychological disturbance attributed to the experience of a major traumatic event – seen after war, rape, major disasters, etc. Symptoms include re-experiencing the traumatic event in the form of nightmares and flashbacks, emotional numbing, alienation, problems in social relations, and elevated arousal, anxiety, and guilt. Think of this stage as the activation of the “fight or flight” system

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The Type A Behavior Pattern (TABP)

  • Impatience
  • Time-urgency
  • Competitiveness
  • Hostility

This last factor, hostility, seems most
associated with increased risk of coronary
heart disease (CHD)

In contract, the Type-B behavior pattern is marked by taking things slower, and being more relaxed in life. Think of the cliché “stop and smell the roses.”

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David Grossman/The Image Works

Acculturative Stress

  • Economic hardship
  • Racism and discrimination
  • Language barriers
  • Eroding of family networks
  • Withdrawal from versus integrating into larger culture

Acculturative Stress refers to the demands faced by immigrants in adjusting to a host (new) culture.

Research finds that adjusting to the demands of the larger culture while maintaining ties with one’s own ethnic identity predicts the best adjustment outcomes.

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Physiological

Responses

to Stress

Hans Selye

John Olson/Time & Life Pictures/Getty Images.

Emotional responses to stress are often accompanied by physiological arousal. Hans Selye, affectionately called “Dr Stress,” conducted pioneering research on the effects of prolonged physiological arousal. Beginning in the 1930s, Selye exposed laboratory animals to a diverse array of physical and psychological stressors, such as heat, cold, pain, mild shock, and restraint. He found that animals displayed a similar pattern of physiological responses to different stressors which he described in terms of the General Adaptation Syndrome (GAS).

 

 

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Time

Level of Resistance

1. Alarm Stage

2. Resistance

3. Exhaustion

Level of
normal resistance

Bodily resources mobilized
to confront stressor

Resistance
remains steady

Bodily resources for handling stress become depleted; negative consequences
may develop (illness or depression)

Based on his research, Hans Selye formulated an influential model of how the body responds to stress, called the general adaptation syndrome. This model posits that the body’s stress response moves through three stages: alarm, resistance, and exhaustion.

In the first stage of the general adaptation syndrome, an alarm reaction occurs when an organism first recognizes the existence of a threat. Arousal increases as the body musters its resources to combat the challenge. Think of this stage as the activation of the “fight or flight” system. Resistance to stress decreases during the alarm reaction, but then increases during the resistance stage when the body attempts to cope.

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Time

Level of Resistance

1. Alarm Stage

2. Resistance

3. Exhaustion

Level of
normal resistance

Bodily resources mobilized
to confront stressor

Resistance
remains steady

Bodily resources for handling stress become depleted; negative consequences
may develop (illness or depression)

As stress continues, an organism may progress to the stage of resistance. During this phase, physiological arousal typically stabilizes at a high level and stress resistance is strong as coping efforts get under way.

 

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Time

Level of Resistance

1. Alarm Stage

2. Resistance

3. Exhaustion

Level of
normal resistance

Bodily resources mobilized
to confront stressor

Resistance
remains steady

Bodily resources for handling stress become depleted; negative consequences
may develop
(illness or depression)

If stress continues for a long time, an organism may reach the stage of exhaustion. In this stage, physiological resources become seriously depleted, and arousal and stress resistance decline, leading in some cases to exhaustion and mental and physical disorders.

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© Cengage Learning

Since Selye’s time, scientists have learned more about the details of physiological reactions to stress. You can read more about this process in the chapter, but the basic steps are:

1) Hypothalamus is activated by the presence of stress

2) Corticotrophin-releasing hormone (CRH) is released

3) CRH stimulates the pituitary gland to release adrenocorticotrophic hormone (ACTH)

4) ACTH stimulates the adrenal cortex to release hormones called corticosteroids

5) The adrenal medulla also releases the stress hormones epinephrine and norepinephrine

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The immune system is the body’s basic defense against illness-causing factors

Lymphocytes

Antigens

Antibodies

Vaccination (immunization)

The relationship between stress and our immune functioning is often misunderstood. Stress depletes our bodies’ ability to fight off foreign agents that can cause illness, and this is why we have a greater tendency to get ill during times of increased stress.

Lymphocytes – specialized white blood cells that “patrol” your bloodstream for the presence of foreign invaders

Antigens – Foreign agents that can cause illness (viruses, bacteria, fungi, etc.)

Antibodies – Specialized protein molecules that fit into antigens like a lock and key and “deactivate” (or neutralize) them.

 

Vaccination –acquired immunity through introduction of dead or weakened forms of infectious agents

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In this video, see how recent research explores the connections between mind and body including the relationship between health and psychological variables such as stress. 

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Social support

Self-efficacy

Internal versus external locus of control

Psychological hardiness
Commitment, openness to challenge,
internal locus of control

Optimism

What part do psychological factors, such as these, play in our response to stress? How is it that some people seem better able to cope with stress?

 

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Ghislain & Marie David de Lossy/The Image Bank/Getty Images

Many factors moderate the effects of stress on illness, and individual differences in impact appear to be related to these moderating variables.

 

Social support, or the various types of aid provided by members of one’s social network, appears to decrease the negative impact of stress.

 

Having an optimistic attitude also appears to lead to more effective coping with stress, while pessimistic attitudes are related to passive coping and poorer health practices.

 

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Module 10.2

Psychological Factors
in Physical Illness

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Stress

Disease

Historically, psychosomatic diseases were defined as physical ailments with a genuine organic basis that are caused in part by psychological factors, especially emotional distress – things like hypertension, ulcers, asthma, eczema, and migraine headaches.

 

Now we know that stress contributes to a diverse array of other diseases once thought to be completely physiologically based and using the term psychosomatic disease as a separate category has fallen into disuse.

 

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Percentage of all deaths

Leading causes of death in the U.S.

Source: Data drawn from Goodarz et al., 2009.

Windows User (WU) – Replace existing graph with Figure 10.7, Deaths associated with individual risk factors, found on page 393.

Behavioral factors, such as diet, exercise, and avoidance of harmful substances such as tobacco, play major roles in many of the nation’s top killers, including heart disease, cancer, stroke, chronic lung disease, and diabetes.

 

Practicing safety behaviors, such as avoiding using a cell phone while driving, can also reduce the risk of serious or fatal accidents. What changes can we make in our daily lives to reduce our risk of these leading killers?

 

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Risk

Low

Moderate

High

Anger Level

Heart disease accounts for nearly one-third of the deaths in the U.S. each year, and atherosclerosis, or gradual narrowing of the coronary arteries, is the principal cause of CHD. Risk factors for CHD include smoking, lack of exercise, high cholesterol levels, and high blood pressure.

Atherosclerosis – a narrowing of major blood vessels, called arteries, due to a fatty buildup of plaque.

Arteriosclerosis – a condition where artery walls become thicker, harder, and less elastic.

Heart attack (myocardial infarction) – Death of heart tissue due to a lack of adequate supply of oxygenated blood.

 

Personality factors have also been linked to risk for coronary heart disease, especially proneness to hostility, which is a part of the Type A behavior pattern. Hostile people are chronically angry and prone to periodic outbursts of anger. Anger can eventually impair the body’s cardiovascular system—the heart and arteries.

 

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Source: NYC Department of Health and Mental Hygiene, 2010

© Sagasan/Shutterstock.com

Health Benefits of Quitting Smoking

After You Quit Smoking…
20 minutes Heart rate drops
12 hours Carbon monoxide level in the blood drops to normal
2 days Ability to smell and taste improve
2 to 3 weeks Heart attack risk begins to drop and lung function improves; walking becomes easier
1 month Coughing and shortness of breath decrease
1 year Risk of heart disease is cut in half
5 years Risk of stroke is reduced to that of a nonsmoker
10 years Risk of dying from lung cancer is about half that of a continuing smoker
15 years Risk of coronary heart disease returns to the level of people who have never smoked

The health benefits associated with quitting smoking (and other uses of tobacco) are numerous. It is NEVER too late to improve your health by quitting. See some suggestions for how to effectively quit your use of tobacco products on page 395.

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Examples of uncontrollable risk factors

Family history

Age

Examples of controllable risk factors

Smoking

Diet and alcohol consumption

Sun exposure

Stress?

What steps are you taking steps to reduce your personal risk of developing cancer? What else can you do?

 

Note that while the role of stress in the development of cancer remains unclear, it still makes sense to limit your exposure to excess stress and learn to manage the stress you face.

 

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Syphilis

Nongonococcal Urethritis
(NGU) in Men

Bacterial STDs

Viral STDs

HIV/AIDS

Gonorrhea

Syphilis

Genital Herpes

Viral Hepatitis

Genital Warts

Our sexual (and drug-using) behavior may also pose health risks by increasing our risk of developing sexually transmitted diseases (also called sexually transmitted infections, or STIs).

 

There are two classes of sexually transmitted disease (STD): bacterial and viral.

 

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Health Threats Posed by STDs

Can cause cervical cancer in women.

HIV/AIDS

Gonorrhea
and Chlamydia

HPV

Syphilis

Potentially fatal if it progresses to full-blown AIDS.

Women: Can lead to pelvic inflammatory
disease and infertility. Men: Can reduce fertility.

Can seriously damage heart and brain if left untreated.

Genital Herpes

Can cause serious complications, especially in women.

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Be careful in choice of sex partners.

Avoid multiple partners, especially partners who themselves have multiple partners.

Communicate your concerns.

Avoid sexual contact with anyone with a sore or blister around the genitals.

Avoid unprotected sexual contact.

Obtain a medical evaluation if suspect may have been exposed to a STD.

Get regular medical checkups to detect and treat disorders we are unaware we may have.

When in doubt, don’t.

Protecting Self and Partners from STDs

How can we protect ourselves and our partners from STDs? How many of these behaviors are we regularly practicing?

 

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Applying Psychology in Daily Life

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Taking the Distress
Out of Stress

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Maintain Stress at a Tolerable Level

Reduce daily hassles.

Know your limits.

Follow a reasonable schedule.

Take frequent breaks.

Develop more effective time-management skills.

Learn to prioritize.

Though stress may be an unavoidable part of life, how we cope with stress lies within our control.

 

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Learn relaxation skills.

Work out daily stress.

Gather information.

Expand your social network.

Take in a comedy tonight.

Prevent burnout.

Replace stress-inducing thoughts with stress-busting thoughts.

Don’t keep upsetting feelings bottled up.

Other Techniques for Managing Stress Effectively

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Control Type A Behavior

Take things slower.

Read books for enjoyment.

Free yourself from digital overload.

Avoid rushing through your meals.

Schedule breaks for yourself.

Set realistic daily goals.

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